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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Kidney stones,lithotripsy,infection,ultrasound,scarred right kidney

Answered by
Dr.
Dr. Rajiv goel

Urologist

Practicing since :1998

Answered : 579 Questions

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Posted on Sat, 26 May 2012 in Kidney Conditions
Question: Hi,
I am a 44 year old female with a history of kidney stones. I had Lithotripsy quite a few years ago and was advised to avoid organ meats, peanuts and iced tea. I did that but the stones returned. I have been able to past the stones since but this last episode was not so great. I should not have tried to 'tough it out'. The stone did a great deal of damage, and left me exposed to an infection (severe). I followed a course of strong antibiotics and cleared the infection but am still dealing with a great deal of right flank pain. On ultra sound the doctors discovered quite a bit of scarring on my right kidney. Is this the cause of my pain? No one can seem to answer this. I have a fairly high pain tolerance and also a need to understand so I can better deal with what I am going through. Thanks for any help you can offer.
doctor
Answered by Dr. Rajiv goel 7 hours later
Hi,
Thanks for the query.

For recurrent stone formation you need to have serum calcium and uric acid estimation done.

In addition, you need to have 24 hr urine calcium, uric acid, oxalate and citrate level estimation. Once these reports are available, you can have dietary modifications for yourself that allow you to not pass the stones.

For controlling the formation of calcium phosphate stones, a moderately low calcium and phosphorus diet should be taken.

Milk should constitute the main source of calcium and curd or cottage cheese, lentils and groundnuts should form the main sources of phosphorus.

Foods which should be avoided are whole wheat flour, Chickpea, pea soyabean, beet, spinach, cauliflower, turnips, carrots, almonds and coconuts.

Tomatoes and dark vegetables like spinach, Swiss chards, beets, okra, and rhubarb are high in oxalates and should not be included in a kidney stone diet.

High sodium or high sugar foods may be restricted in a kidney stone diet.

Drinking plenty of water and fluids is an integral part of a kidney stones diet.

As far as your pain and damage issues are concerned, I am interested to know whether you have been subjected to CT urogram or not.

Hope i have answered your query, i will be available for follow up.
Above answer was peer-reviewed by : Dr. Radhika
doctor
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Follow up: Dr. Rajiv goel 22 hours later
Thank you for your comments. I am sure I have no stones at the moment. I have had an abdominal CT, but not with contrast.

My concern is the continuing right flank pain. I do not understand why it is continuing if there is no longer infection. (And all stones have been passed.)

The report for the ultrasound is as follows:
COMMENTS
Abdominal Ultrasound:


Comparison was made with a prior ultrasound scan performed on
02/09/2007.

LIVER: The echogenicity of the liver appears increased.

BILIARY TREE: The common bile duct measures 2.0 mm. The size of
the intrahepatic ducts appears normal.

GALLBLADDER: The gallbladder appears normal. Gallbladder wall
appears normal and measures 2.0 mm.

PANCREAS: The visualized portions of the pancreas appear normal.

AORTA: The visualized portions of the aorta appear normal.

INFERIOR VENA CAVA: The visualized portions of the IVC appear
normal.

RIGHT KIDNEY: Possible scarring is seen in the right kidney. The
right kidney measures 9.2 cm in length. The echogenicity of the
right kidney is normal. The right kidney demonstrates no
hydronephrosis.

LEFT KIDNEY: The left kidney measures 9.8 cm in length. The
echogenicity of the left kidney is normal. The left kidney
demonstrates no hydronephrosis.

SPLEEN: The visualized portions of the spleen appear normal.

IMPRESSION:
Fatty liver.

END REPORT

I have been advised to just take pain medication and I am uncomfortable doing so. I don't know if I have a need to be concerned or not. I typically run low on both body temperature and blood pressure. 96.2 is average body temp and blood pressure runs on average 96/54. This does not concern me as it appears to be 'normal' for me.

I am 5'3", 102 lbs. I drink socially, but not a lot. I am vegetarian and try to eat healthy. My eating habits of late are not good as eating intensifies the pain.

Thank you.
doctor
Answered by Dr. Rajiv goel 2 hours later
Hi,
Thanks for the follow up.

Your kidney seems to be in pink of health at this point of time and does not need any treatment and is unlikely to be the cause of pain.

You have gone through a lot and possibility of your having stress related acid peptic disease is very high.

Intensification of pain after intake of food also suggests the same. I will suggest that you take some H2 blocker such as rabeprazole or TUMS , Pepcid-AC and see the difference.

Hope i have answered your query.

Wishing you good health.

Above answer was peer-reviewed by : Dr. Radhika
doctor
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